Individual
MARK W BIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 WASHINGTON AVE., ORTING, WA 98360
(253) 759-0350
Mailing address
PO BOX 174, ORTING, WA 98360-0174
(253) 759-0350
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000257
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5033642
—
WA
Enumeration date
04/09/2008
Last updated
04/09/2008
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